Selected Abstracts

Leiomyoma of the urinary bladder during pregnancy

INTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2003KENTARO MIZUNO
Abstract
We present a rare case of leiomyoma of the urinary bladder that was diagnosed during pregnancy.
To our knowledge, this is the fourth case of its kind to be reported in the literature.
Ultrasonography, magnetic resonance imaging and biopsy were useful for making an accurate diagnosis in this case.
The diagnosis was confirmed by suprapubic transcutaneous needle biopsy.
The tumor was resected approximately 3 years after diagnosis, during which period the patient delivered a normal baby by caesarian section.
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ORIGINAL ARTICLE: Uterine Leiomyoma is Associated with a Polymorphism in the Interleukin 1-, Gene

AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 2 2009Detlef Pietrowski
Problem, To investigate whether polymorphisms in the interleukin-1, (IL-1,) gene are associated with uterine leiomyoma.
Method of study, Case,control study in a collective of 131 patients and 280 controls.
Genotyping of the IL-1,-511 and IL-1,-3954 polymorphism was performed by PCR amplification and subsequent RFLP analysis.
Results, A significant difference in the allele frequencies of the IL-1,-511 Cleiomyoma, suggesting that this polymorphism does contribute to the development of this disease.
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Vascular Leiomyoma of the Head and Neck

THE LARYNGOSCOPE, Issue 4 2004Cheng-Ping Wang MD
Abstract
Objectives/Hypothesis Vascular leiomyoma, a benign tumor composed of smooth muscle cell and vascular endothelium, is rare in the head and neck region.
The authors report their experience with 21 patients.
Study Design Retrospective review.
Methods From 1988 to 2001, the clinical records of 21 patients with vascular leiomyoma of the head and neck were reviewed.
The pathological material of each tumor was reviewed again for confirmation of the diagnosis and histological classification proposed by Morimoto.
Results Twelve male and 9 female patients were studied.
The mean age was 48 years.
The locations and numbers of cases of the tumors were as follows: auricle, five; nasal cavity, three; external nose, 3; neck, 3; lip, 3; inner canthus, 2; forehead, 1; and hard palate, 1.
All tumors were painless, and most were less than 2 cm in diameter.
Three vascular leiomyomas of the neck were larger than 2 cm.
Two of the three tumors originating in the nasal cavity presented with nasal obstruction or epistaxis.
Regarding histological subtype, 14 of 21 (67%) tumors were solid type; 6 (28%) were cavernous type, and only one (5%) was venous type.
Only one tumor (5%) recurred after excision.
Conclusion Vascular leiomyoma usually presents as a small, painless mass.
Auricle, nose, lip, and neck are the most common sites of occurrence.
Unusually large vascular leiomyomas are developed in the deep space of the neck.
Imaging study or cytological examination is not helpful for diagnosis.
Histological classification is not necessary.
Simple excision yields excellent results.
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CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 4 2005Rohan Merani MB BS MMed
Abstract
Orbital leiomyoma is a benign tumour of smooth muscle origin that can be clinically, radiologically and histopathologically difficult, to, diagnose, due, to, the, rarity, of, leiomyomas, in this location.
A 74-year-old woman presented with a, 2-month history of painless proptosis.
Computed tomography and magnetic resonance imaging studies revealed a well-circumscribed intraconal lesion separate from the optic nerve, and not eroding adjacent bone.
A right lateral orbitotomy via a lid crease incision was performed to remove the firm lobulated lesion.
Postoperatively there was an obvious decrease in proptosis.
Microscopically the lesion was a well-circumscribed tumour composed of spindle cells.
There were no light microscopic features to suggest malignancy, and immunohistochemistry was used to confirm the diagnosis of leiomyoma.
Leiomyoma is a tumour that is rarely found in the orbit most likely due to the paucity of smooth muscle in this location.
The differential diagnosis is wide, and the role of radiology, histology and immunohistochemistry in the diagnosis of leiomyoma is discussed.
Surgical excision in this case excluded malignancy, provided a definitive diagnosis of a rare entity and resulted in marked clinical improvement.
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Cytomorphological study of soft tissue neoplasms: role of fluorescent immunocytochemistry in diagnosis

CYTOPATHOLOGY, Issue 5 2005B. Rekhi
Objectives:, Exact categorization of soft tissue tumours (STTs) on smears requires application of various ancillary techniques.
This study was aimed at evaluating the role of fluorescent immunocytochemistry (FICC) in cyto-diagnosis of 30 STT cases.
Methods:, Thirty cases of soft tissue tumours were included in the present study.
All cases were subjected to routine Giemsa and Papanicolaou stain.
Extra smears were made and kept for fluorescent immunostaining.
A panel of cytoskeletal antibodies, tagged with FITC (Fluorescein isothyocynate), was employed in all these cases.
Fluorescent immunostained smears were examined under Zeiss Confocal Laser scanning microscope, using double immunofluorescence (red-green).
Finally, all cases were subjected to biopsy and again immunoperoxidase staining.
Results:, Among the 30 cases in the present study, unaided cytological diagnoses ranged from ,spindle cell' tumour in four (13.3%) cases, benign and malignant spindle cell tumour in 17 (56.6%) cases, to malignant mesenchymal tumour in nine (30%) cases.
FICC helped in further correct categorization of 25/30 (83.3%) cases viz. leiomyoma (three), benign neurogenic tumour (six), schwannoma (one), dermatofibrosarcoma protuberans (three), synovial sarcoma (two), rhabdomyosarcoma (two), malignant fibrous histiocytoma (five) and malignant peripheral nerve sheath tumour (three).
Aggressive fibromatosis was found to be a missed diagnosis in two cases.
Overall concordance between cyto-diagnosis with FICC, and histopathology results was 83.3% (P < 0.05).
Conclusion:, Fluorescent immunocytochemistry is a significant ancillary technique for making a rapid and specific diagnosis of STT, as required for their timely management.
Incorporation of a wide panel of antibody markers with clinico-cytological correlation is recommended in forming an exact diagnosis in these cases.
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DISEASES OF THE ESOPHAGUS, Issue 3 2009G. Jiang
SUMMARY
Esophageal leiomyoma is the most common benign esophageal tumor.
Thoracoscopic enucleation is currently a preferred approach to most of these lesions.
We present our experiences of enucleation of these tumors using thoracoscopic approach.
A retrospective review of 40 patients who underwent enucleation of esophageal leiomyoma from 1997 to 2007 in our institute was conducted.
Presenting symptoms, operative approach, tumor size, tumor shape, outcomes, and indication for this approach were analyzed.
Forty patients were identified.
Postoperative histopathology confirmed the leiomyoma in all patients.
The thoracoscopic enucleation was completed in 34 cases, and the operation was converted to open procedure in six cases.
Reasons for conversion included too small tumors to be visualized in two cases, thoracic cavity adhesion in one case, and the too large tumors in three cases.
The median operating time was 70 min (50 to 210 min).
Mean tumor size was 3.7 cm (0.5,10 cm).
There were no major postoperative complications.
Symptoms especially dysphasia were relieved postoperatively.
Short- and long-term follow-up was satisfactory with none of the patients having tumor recurrences or other problems.
Thoracoscopic enucleation of esophageal leiomyoma is technically safe and effective.
It is currently the best choice for management of esophageal leiomyoma 1 to 5 cm in diameter.
It can also be tried on a tumor larger than 5 cm, although the possibility of conversion to thoracotomy increases along with tumor growing and surrounding the esophagus.
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Surgical treatment of esophageal leiomyoma located near or at the esophagogastric junction via a thoracoscopic approach

DISEASES OF THE ESOPHAGUS, Issue 2 2009Z. G. Li
SUMMARY
Esophageal leiomyoma can be enucleated safely and effectively by minimally invasive surgery.
The laparoscopic approach has been a conventional option for this kind of tumor located near or at the esophagogastric (EG) junction.
The aims of this study were to evaluate the surgical outcome of thoracoscopic resection of leiomyoma at the EG junction, and discuss factors affecting the incidence of postoperative gastroesophageal reflux.
Fourteen patients who underwent thoracoscopic resection of esophageal leiomyoma located near or at the EG junction (<4 cm above the esophageal hiatus) from January 2002 to August 2007 were reviewed retrospectively.
Tumor characteristics, surgical methods, and postoperative outcomes were evaluated.
A left approach of video-assisted thoracoscopy was used in 13 patients; a right approach was used for the other patient, whose multiple tumors were located in the EG junction and mid-esophagus.
Postoperative recovery was uneventful in all patients, with no mucosa leakage or other significant complications.
Mean tumor size was 3.2 cm (1.2,6.0 cm).
Of the 14 patients, two had serpiginous leiomyoma, two had multiple tumors, and the others had solitary tumors.
Mean postoperative stay in hospital was 7 days (4,11 days).
Postoperative dysphagia was not reported, although gastroesophageal reflux was noted in one patient.
Thoracoscopic resection of esophageal leiomyomas near or at the EG junction is feasible, with a low prevalence of postoperative gastroesophageal reflux.
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Frequency and characterization of HMGA2 and HMGA1 rearrangements in mesenchymal tumors of the lower genital tract

Leiomyoma of the urinary bladder during pregnancy

INTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2003KENTARO MIZUNO
Abstract
We present a rare case of leiomyoma of the urinary bladder that was diagnosed during pregnancy.
To our knowledge, this is the fourth case of its kind to be reported in the literature.
Ultrasonography, magnetic resonance imaging and biopsy were useful for making an accurate diagnosis in this case.
The diagnosis was confirmed by suprapubic transcutaneous needle biopsy.
The tumor was resected approximately 3 years after diagnosis, during which period the patient delivered a normal baby by caesarian section.
[source]

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 3 2008Naila Usmani
We describe the case of a cutaneous symplastic leiomyoma in a 37-year-old woman who presented with a 4-year history of a painful slow growing lesion on the left upper arm.
The lesion was excised and subjected to histological examination.
A poorly circumscribed lesion was seen in the dermis composed of spindle shaped cells with marked nuclear pleomorphism.
No mitotic figures or necrosis were seen.
The cells stained strongly positive with desmin and smooth muscle actin, and negative with S100, melan A, MNF116 a mouse monoclonal antibody to cytokeratin and CK5/6.
The diagnosis was felt to be in keeping with a cutaneous symplastic leiomyoma, a rarely reported variant of the pilar leiomyoma.
Histologically, it shows features similar to the symplastic variant of uterine leiomyoma with cytological atypia, nuclear pleomorphism and minimal mitotic activity.
Although the long-term outlook is probably benign, the presence of cytological atypia and mitoses in any spindle cell tumor is generally a concerning feature and warrants long-term follow up.
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Male genital leiomyomas showing androgen receptor expression

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 12 2007José Manuel Suárez-Peñaranda
Genital leiomyoma in men include those superficial leiomyomas arising in the scrotum and the areola.
They are unusual neoplasms: few cases have been reported in the literature and they usually escape clinical diagnosis.
Three cases of male genital leiomyomas are reported: two in the scrotum and one in the areola.
They were all conservatively excised and the behaviour was completely benign in all cases.
Histopathological examination showed the typical findings of superficial leiomyomas, with some minor differences between cases arising in the scrotum and those from the areola.
Immunohistochemical findings not only confirmed the smooth muscle nature of all cases but also showed unequivocal immunostaining for androgen receptors in the leiomyomas from the scrotum.
Immunostaining for androgen receptors in scrotal leiomyomas is, as far as we are aware, a previously unknown characteristic of male genital leiomyomas.
This finding supports the role of steroid hormones in the growth of genital leiomyomas, similar to leiomyomas found in other locations.
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Granular cell atypical fibroxanthoma

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 4 2005Sarah N. Rudisaile
Both neoplasms were solitary, light-tan, dome-shaped papules on sun-exposed areas of the head in two elderly white men.
Microscopically, these neoplasms showed a dermal proliferation of pleomorphic granular cells with irregular hyperchromatic nuclei, multinucleated cells, and scattered mitoses.
Immunohistochemical stains were positive for CD68 and vimentin and negative for Melan-A or human melanoma black (HMB)-45, S-100 protein, pancytokeratin, and actin, consistent with atypical fibroxanthoma.
The differential diagnosis of granular cells in neoplasms containing cytological pleomorphism is challenging in view of the many different neoplasms that may present with granular cytoplasm.
These include the conventional granular cell tumor and its malignant form, leiomyoma, leiomyosarcoma, dermatofibroma, dermatofibrosarcoma protuberans, and angiosarcoma.
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Uterine artery occlusion and myomectomy for treatment of pregnant women with uterine leiomyomas who are undergoing cesarean section

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2010Jui-Yu Lin
Abstract
Aim:, To evaluate the efficacy of uterine artery occlusion and myomectomy (UAO+M) for pregnant women with uterine leiomyomas who are undergoing cesarean section (CS).
Methods:, Seventy-two women with uterine leiomyomas undergoing CS for obstetrical reasons were enrolled into this case,control study.
Thirty-six patients underwent UAO+M during CS (UAO+M group), and 36 received CS alone (Control group).
The UAO+M procedure was performed immediately after closure of the uterine incision wound.
The outcome was measured by comparing surgical techniques, and future surgical intervention (myomectomy, uterine vessel occlusion or hysterectomy) for symptomatic leiomyoma.
Results:, The average follow-up time was 63 months.
General characteristics of the patients were similar in both groups.
There were no statistical differences in intraoperative blood loss, postoperative recovery, complications, or wound pain between the two groups.
The operative time was significantly longer in the UAO+M group compared with that in the Control group, but the further surgical intervention rate was significantly lower in the UAO+M group than in the Control group (2.8% vs 41.7%, P < 0.001).
Seven patients (19%) in the UAO+M group and five (14%) in the Control group had a repeat CS during the follow-up period.
Conclusion:, UAO+M could be considered for treating pregnant women with uterine leiomyomas who are undergoing CS, compared with observation, as this procedure can minimize the necessity for future surgery, with increased operative time for the UAO+M procedure, but without increased surgical morbidity.
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Retroperitoneal uterine leiomyoma occurring 5 years after hysterectomy for fibroids

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 6 2007Nobuyuki Fukamachi
Abstract
We encountered a 49-year-old, multiparous female with a very rare isolated retroperitoneal uterine leiomyoma measuring 72 × 43 mm in diameter occurring 5 years after hysterectomy for fibroids.
The case was preliminarily diagnosed as right ovarian cancer or fibroma.
An edematous, isolated solid tumor in the right retroperitoneal cavity was surgically resected.
Pathological findings demonstrated uterine leiomyoma.
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Gastric Neoplasia in Horses

JOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2009S.D. Taylor
Background: Gastric neoplasia of horses is incompletely described.
Objective: Provide history, clinical signs, and clinicopathological and pathological findings associated with gastric neoplasia in horses.
Animals: Twenty-four horses with gastric neoplasia.
Methods: Retrospective study.
History, clinical signs, and clinicopathological and pathologic findings in horses diagnosed histologically with gastric neoplasia were reviewed.
Results: Horses ranged in age from 9 to 25 years (median 18 years at presentation).
There was no apparent breed or sex predisposition.
The most common presenting complaints were inappetance (17/24), weight loss (14/24), lethargy (7/24), hypersalivation (7/24), colic (5/24), and fever (5/24).
The most consistent clinical signs were tachypnea (10/19), decreased borborygmi (8/19), and low body weight (7/17).
Useful diagnostic tests included rectal examination, routine blood analysis, gastroscopy, abdominocentesis, and transabdominal ultrasound examination.
Anemia was the most common hematologic abnormality encountered (7/19), and hypercalcemia of malignancy was seen in 4/16 horses.
Squamous cell carcinoma was the most common tumor identified (19/24), and was most often (14/19) found as a single ulcerated, necrotic mass in the nonglandular portion of the stomach.
Other gastric neoplasms encountered were leiomyoma (n=2), mesothelioma (n=1), adenocarcinoma (n=1), and lymphoma (n=1).
Metastatic neoplasia was found in 18/23 horses.
The median time from onset of clinical signs to death was 4 weeks, and all horses died or were euthanized because of gastric neoplasia.
Conclusions: Squamous cell carcinoma is the most common primary gastric neoplasia in horses.
The survival time after diagnosis of gastric neoplasia in horses is short.
[source]

Angiotensin I-converting enzyme insertion-related genotypes and allele are associated with higher susceptibility of endometriosis and leiomyoma,,§

Intraparenchymal myofibromatosis of the brain in an adult: report of an unusual case

NEUROPATHOLOGY, Issue 3 2010Hua-liang Xiao
An unusual case of intraparenchymal myofibromatosis of the brain occurring in a 29-year-old woman is described.
Preoperative CT and MRI examinations revealed two well-circumscribed nodular masses localized in the wall of the left lateral ventricle and right temporal lobe, respectively.
Both masses were completely resected, and the patient remains disease-free 2 years post-surgery.
Histopathologically, the lesions were characterized by stratification.
From outer to inner, there was a reactive glial component, lamellated well-differentiated muscle-like cells, densely compact collagen fibers and cellular tumor with nodular and hemangiopericytoma-like patterns, respectively.
The myofibroblastic nature of this tumor was verified by immunohistochemical staining and ultrastructural analysis.
Intraparenchymal myofibromatosis may be confused with, and should be distinguished from, meningioma, myopericytoma, solitary fibrous tumor, leiomyoma and inflammatory myofibroblastic tumor for accurate diagnosis and optimal treatment.
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Uterine lipoleiomyoma: A histopathological review of 17 cases

PATHOLOGY INTERNATIONAL, Issue 10 2004Thida Aung
Lipoleiomyoma is a rare uterine tumor.
The exact frequency and proliferation activity are not yet known.
This study aims to know the frequency and evaluate the relation with renal angiomyolipoma.
Lipoleiomyoma cases were immunohistochemically stained by antibodies for Ki-67, melanoma specific antigen HMB45, S-100 protein, and , smooth muscle actin (,-SMA).
Frequency of uterine lipoleiomyoma among ,uterine ,myomatous ,tumor ,was ,17/4904 ,(0.35%) ,in the Department of Human Pathology, Field of Oncology, Kagoshima University Graduate School database (1983,2003).
Patients ranged from 45 to 74 years of age, and 10 cases were associated with leiomyoma.
Six of 17 (35%) cases showed areas with renal angiomyolipoma-like vessels and atypical cellular features.
Immunostaining was available in 12 cases.
By Ki-67 labeling index, both muscle (average 1.38%) and fat (average 1.17%) portions of the tumor had greater proliferation than normal myometrium (average 0.76%), which suggests that fat portions of the tumor are proliferating adipose tissue rather than fatty degeneration of muscular counterpart.
HMB45 antigen, which is positive in renal angiomyolipoma, was negative in three uterine cases having angiomyolipoma-like vessels (3/12).
However, HMB45 antigen was positive in spindle-shaped tumor cells of three cases (3/12) which lacked angiomyolipoma-like vessels.
Presence of angiomyolipoma-like blood vessels in these tumors is not an uncommon feature.
However, the diagnosis of uterine angiomyolipoma should not be based on the result of HMB45 antigen immunoreactivity alone.
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Marked diffuse dilations of the biliary tree associated with intrahepatic calculi, biliary sludges and a mucinous cyst of the pancreatic head in a 99-year-old woman

PATHOLOGY INTERNATIONAL, Issue 8 2003Tadashi Terada
A 99-year-old woman was admitted to Shizuoka Shimizu Municipal Hospital because of fever and anasarca.
Imaging and laboratory tests showed pneumonia, urinary tract infection, and cardiac failure.
The patient died 20 days after admission.
An autopsy revealed marked diffuse dilations of the biliary tree ranging from the lower common bile duct to intrahepatic bile ducts.
Intrahepatic calcium bilirubinate stones and biliary sludges were recognized within the dilated bile ducts.
A unilocular cyst (2 cm in diameter) was present in the pancreatic head adjacent to the lower common bile duct, and it appeared to compress the common bile duct.
Histologically, the walls of the dilated biliary tree showed proliferation of peribiliary glands, fibrosis, and infiltration of lymphocytes and neutrophils (cholangitis).
The lumens of the dilated biliary ducts contained neutral and acidic mucins, fibrinous materials, bacteria, neutrophils, and Aspergillus fungi, in addition to the calculi and sludges.
The background liver showed atrophy (400 g).
The pancreatic unilocular cyst was composed of mucous columnar cells with a few infoldings, and the pancreas also showed foci of mucinous duct hyperplasia and ectasia; the pathological diagnosis of the cyst was cystic dilations of a pancreatic duct branch (mucinous ductal ectasia or mucinous cyst).
Other lesions included aspiration pneumonia, emaciation, atrophy of systemic organs, gastric leiomyoma, serous cystadenoma of the right ovary, and arteriosclerotic nephrosclerosis.
The present case suggests that a mucinous cyst of the pancreas may compress the biliary tree and lead to marked diffuse dilations of the biliary tree.
Alternatively, the dilations of the bile ducts may be associated with aging or may be of congenital origin.
The dilated bile ducts may, in turn, give rise to bacterial and fungal cholangitis and formation of biliary sludges and intrahepatic calcium bilirubinate stones.
[source]

ORIGINAL ARTICLE: Uterine Leiomyoma is Associated with a Polymorphism in the Interleukin 1-, Gene

AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 2 2009Detlef Pietrowski
Problem, To investigate whether polymorphisms in the interleukin-1, (IL-1,) gene are associated with uterine leiomyoma.
Method of study, Case,control study in a collective of 131 patients and 280 controls.
Genotyping of the IL-1,-511 and IL-1,-3954 polymorphism was performed by PCR amplification and subsequent RFLP analysis.
Results, A significant difference in the allele frequencies of the IL-1,-511 Cleiomyoma, suggesting that this polymorphism does contribute to the development of this disease.
[source]

Vascular Leiomyoma of the Head and Neck

THE LARYNGOSCOPE, Issue 4 2004Cheng-Ping Wang MD
Abstract
Objectives/Hypothesis Vascular leiomyoma, a benign tumor composed of smooth muscle cell and vascular endothelium, is rare in the head and neck region.
The authors report their experience with 21 patients.
Study Design Retrospective review.
Methods From 1988 to 2001, the clinical records of 21 patients with vascular leiomyoma of the head and neck were reviewed.
The pathological material of each tumor was reviewed again for confirmation of the diagnosis and histological classification proposed by Morimoto.
Results Twelve male and 9 female patients were studied.
The mean age was 48 years.
The locations and numbers of cases of the tumors were as follows: auricle, five; nasal cavity, three; external nose, 3; neck, 3; lip, 3; inner canthus, 2; forehead, 1; and hard palate, 1.
All tumors were painless, and most were less than 2 cm in diameter.
Three vascular leiomyomas of the neck were larger than 2 cm.
Two of the three tumors originating in the nasal cavity presented with nasal obstruction or epistaxis.
Regarding histological subtype, 14 of 21 (67%) tumors were solid type; 6 (28%) were cavernous type, and only one (5%) was venous type.
Only one tumor (5%) recurred after excision.
Conclusion Vascular leiomyoma usually presents as a small, painless mass.
Auricle, nose, lip, and neck are the most common sites of occurrence.
Unusually large vascular leiomyomas are developed in the deep space of the neck.
Imaging study or cytological examination is not helpful for diagnosis.
Histological classification is not necessary.
Simple excision yields excellent results.
[source]

Cotyledonoid dissecting leiomyoma of the uterus: a report of four cases

APMIS, Issue 4 2010MASAHARU FUKUNAGA
No abstract is available for this article.
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AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009Madhu BAGARIA
Aims: To evaluate the effect of low-dose mifepristone on leiomyoma-related symptoms, uterine and leiomyoma in women with symptomatic leiomyomata.
Methods: In a double-blind placebo-controlled trial, 40 patients with symptomatic leiomyoma and normal endometrial histology were randomised to receive 10 mg mifepristone (group 1) or placebo (group 2) daily for three months.
Leiomyoma-related symptoms, uterine, leiomyoma and largest leiomyoma volumes were assessed at baseline and every month for three months.
Endometrial biopsy was repeated at the end of therapy.
Results: Significant change was noticed between the two groups for mean menstrual blood loss (MBL) by first month.
Menstrual blood loss declined by 94.8% in group 1 at three months and 84.2% patients attained amenorrhoea in this group.
In group 1 complete relief of dysmenorrhoea occurred in significant number of women (80%) but only 33% patients got rid of pelvic pain.
There was no change in these symptoms in group 1 Backache, urinary complaints and dyspareunia were not relieved in either group.
Uterine, leiomyoma and largest leiomyoma volume declined by 26,32% in group 1 as compared to none in group 2, and this difference was statistically significant only by the end of the third month of therapy.
Mean haemoglobin increased from 9.5 to 11.2 g/dL in group 1.
In group 1, at the end of therapy, 63.1% of patients had endometrial hyperplasia without atypia.
Conclusions: Ten milligrams mifepristone for three months is effective in reducing MBL, increasing haemoglobin and reducing uterine and leiomyoma volume with side-effect of endometrial hyperplasia.
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A huge ,prostate-mimicking' vaginal leiomyoma with simultaneous expression of oestrogen and progesterone receptors

ACTA OPHTHALMOLOGICA, Issue 2009A SCHALENBOURG
Purpose In the presence of a ciliary body or choroidal tumor of undetermined origin, an open-sky biopsy is performed in selected cases to establish a diagnosis and specify the therapeutic approach.
We explored the frequency and reliability of this diagnostic procedure.
Methods Retrospective, consecutive, histopathologic case series of 30 biopsies since 1989 of ciliary body or choroidal tumors of undetermined origin.
Results Eighteen tumors originated from the ciliary body, 12 from the choroid.
Diagnosis was respectively adenoma/adenocarcinoma (4;0), mesectodermal leiomyoma (4;1), metastatic tumor (2;0), melanocytic tumor (4;5), lymphoma (1;3); hemangioma (1;0) or posterior nodular scleritis (0;3).
In 2 cases, there was insufficient material to make a diagnosis.
There were no cases where the biopsy complicated local or systemic tumor control.
Conclusion Open-sky biopsy is only performed in cases whose clinical appearance doesn't permit to confidently establish a diagnosis; its goal is to guide the therapeutic approach.
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